Healthcare Provider Details

I. General information

NPI: 1780183129
Provider Name (Legal Business Name): VIVIAN LAZATIN CAYABYAB APRN AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VIVIAN LAZATIN CAYABYAB APRN

II. Dates (important events)

Enumeration Date: 02/12/2018
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 MEDICAL PARKWAY
CARSON NV
89703
US

IV. Provider business mailing address

325 HARBOUR COVE DR STE 319
SPARKS NV
89434-7860
US

V. Phone/Fax

Practice location:
  • Phone: 775-445-8795
  • Fax:
Mailing address:
  • Phone: 702-285-9779
  • Fax: 702-285-9779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN002795
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN002795
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN002795
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN76135
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberAPRN002795
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: